Epilepsy is a nuerological illness which can appear at any age, although it is more frequent at both ends of the age spectrum.

Epilepsy does not recognise gender, age or race.

There is not one test to prove epilepsy. The most important thing is to get a detailed description of the seizure. It is fundamental to go to a nuerologist with a family member or somebody who can provide evidence of the seizure. Once a diagnosis has been made this will be complemented by tests which will help to detect the origin of the seizure.  

The most important tests are:

• Tomography Axial Computer (o TAC) brain
• Cerebral Magnetic Resonance
• The Electroencephalogram

Epilepsy is a treatable condition. Fortunately 80% of those affected can control seizures with anti epileptic medication. There are a further 20% for whom medication does not work : these people have refractory or drug resistant epilepsy, and they may be candidates for surgery. Other treatments for those who have difficult to control epilepsy are : cetogena diet or implantation of a pacemaker in the lazy nerve.  

Treatment of epilepsy should have a holistic and whole person approach to improve the quality of life of the patient.

The ability to work will depend on the frequency of seizures. In benign epilepsy (well controled) any activities can be undertaken, although there are certain professions which by law people with epilepsy cannot do eg professional driver, pilot, armed forces, police etc. For those people with frequent seizures the possibility of finding and keeping a job are scarce. Generally this is because of the reaction of others when faced with a seizure not because the person with epilepsy puts any obstacles in the way.

A frequent problem for those with epilepsy is that they have to declare their illness when seeking employment. Many prefer to hide their illness and earn respect in the hope that their bosses, when they find out, will realise that their personal qualities outweigh their illness. In fact, diverse investigation works have demonstrated that people with epilepsy have less work accidents, less days off work and they are more loyal to the company which employs them, compared to people without this illness.

Many private insurance companies will not provide cover for pre-existing illnesses, including epilepsy. Therefore those with epilepsy are unable to get private medicine.

Domestic accidents are very frequently the cause of personal injury and on some occassions are very serious. People with epilepsy are subject to the possibility that a seizure could happen whilst undertaking everyday tasks, because of this the risk of accident is relatively high.

Making the house as safe as possible requires special precautions: Shower instead of bathing, doors that open outwards (so as not to block the opening in case of a crisis), avoid glass doors, etc.

Your neurologist or paedatric nuerologist are the professionals who can best provide information about this pathology. Quality complementary information can be found in the Associations, Federations and Foundations who are dedicated to defending the rights of those affected by epilepsy and their families.

The majority of epileptic seizures start in childhood because of the brain´s immaturity and, sometimes, they disappear when the child grows. In infancy epilepsy has its own characteristics in how it presents clinically, and in its diagnosis and medical treatment, as well as its cognitive and phsycosocial effects.

When should treatment start

Treatment is not administered to the patient after a first seizure because there is a 50% probability that it will not re-occur. Treatment should only be started after 2 or more seizures, and when the incidences have been well researched and they are sure that it is epilepsy.

Epilepsy is the most frequent nuerological disorder in adolescence and approximately 2% of the adolescent population will have the disorder. For these adolescents epilepsy has an impact on this changing stage of their lives. 

Frequently the seizures are not preceded by any symptoms and can happen at any time. Sport, leisure and free time are not triggers for a seizure but the adolescent can be frightened that these activities could provoke a seizure, these beliefs can only worsen the situation. The adolescent may feel that they have no control over their own lives and on many occassions can demonstrate bad behaviour and thoughts to his/her fellow students, at work, with friends and within their family. This will have an impact in his/her personal, social and work situation.

At the onset of adolescence women go through important changes. In this stage of life there are a series of hormonal changes that end some epilepsies and start others. Imformation about menstruation, contraception and pregnancy should be provided to the adolescent.

What are hormones?

Hormones are chemical substances that are formed in organs and glands and are transported around the body by the blood stream. They control various biological processes, not least of all the menstrual cycle. Steriod hormones include the most important group of sexual hormones ; oestrogen, androgen and progesterone. These three goups are present in both men and women but in different quantities.

Epilepsy affects people of all ages, however older people and children are more likely to get the condition.

In Spain, approximately 50.000 older people have epilepsy (15 in every 1.000 of over 75's) primarily because of cerebral vascular illnesses and dementia.

Epilepsy is an illness which is unknown throughout the majority of the population and because of this, those who have epilepsy suffer social stigma. This becomes worse for the older person because the problems associated with the illness are added to ongoing difficulties such as income, loss of independence and an increase in admissions to old people's homes and other institutions.

The vagus nerve stimulator is a battery operated device (very similar to a pacemaker) which is surgically implanted under the breast skin and connected to the vagus nerve at the bottom part of the neck. This device sends electrical impulses to the brain through the vagus nerve and can give a 20% to 40% reduction in convulsions. Patients have to continue to take their anti-epileptic drugs but they have fewer seizures and medication dosage can be reduced.

Side effects caused by the vagus nerve stimulator are minor but can include hoarseness, ear pain, sore throat and nauseas. It is very important to adjust the amount of stimulation so as to eliminate the majority of the side effects.

The vagus nerve stimulator's batteries need to be changed about every five years ; this will require minor surgery and generally can be carried out in outpatients.

Surgery for epileptic patients is used to improve quality of life. It is for patients who do not respond to anti-epileptic drugs.

The objective of surgery is to eliminate or reduce seizures and enable an improvement in quality of life. Surgery can also help to adapt better to psychosocial and professional life.

Because each individual's epilepsy is different a series of tests have to take place before operating. The usual tests are high definition resonance, EGG video study and a specific neuropsychological study.